Pain Relief

Physical pain is a fairly common occurrence in life, so I suppose everyone walks around figuring it’s a sensation they’re familiar with. But something I learned over this past week is that there was a whole new level of pain far beyond anything I’d previously experienced. In my case, it was caused by a small cyst growing beneath one of my wisdom teeth that was pressing on a nerve in my jaw. And, fortunately, it was easy for an oral surgeon to remove. But it hurt a lot while it lasted, and the experience was terrible.
It made me think back to complaints I’d read and briefly acknowledged over the years about how the “war on drugs” has interfered with medical efforts to treat pain. As Mark Kleiman put it:
Physicians and their regulators are naturally concerned about the risk of iatrogenic (treatment-induced) drug dependency. Consequently, they have tended to be sparing in their use of opiate and opioid pain relievers, even when the pain involved is extreme and the patient’s short life expectancy, as in the case of terminal cancer patients, makes addiction a largely notional problem. Better professional education has made more recent cohorts of physicians less afraid of over-prescribing painkillers than their older colleagues, but the upsurge of prescription-analgesic abuse (especially of hydrocodone [Vicodin] and oxycodone [Percodan, Oxycontin]) has generated a backlash. [...]
Current policies are scaring physicians away from treating pain aggressively. Many doctors and medical groups now simply refuse to write prescriptions for any substance in Schedule II, the most tightly regulated group of prescription drugs, including the most potent opiate and opioid pain-relievers and the potent amphetamine stimulants. The opiate-and-stimulant combination the textbooks recommend for treating chronic pain is almost never given in practice for fear (a fear well in excess of the actual risk) of disciplinary action and criminal investigation for a physician prescribing “uppers and downers” together. It’s time to loosen up.
This is terrible. One of the most interesting findings from the happiness research literature is that human beings are remarkably good at adapting to all kinds of misfortunes. Chronic pain, however, is an exception. People either get effective treatment for their pain, or else they’re miserable. Adaptation is fairly minimum. The upshot is that from a real human welfare perspective, we ought to put a lot of weight on making sure that people with chronic pain get the best treatment possible. Minimizing addiction is a fine public policy goal, but the priority should be on making sure that people with legitimate needs can get medicine.

Related

Medical professionals and addiction specialists are calling for the Food and Drug Administration to revoke its approval of a painkiller they say could be deadly and lead to another spike in opioid addiction. The FDA approved the drug Zohydro in the fall, and it's expected to be available to patients with chronic pain starting in March, according to CNN.

OTTAWA — Health Canada is toughening warning labels for controlled-released prescription narcotics as part of efforts to curb rampant prescription drug abuse, federal health minister Rona Ambrose announced Monday at the opening session of the 147th annual gathering of the nation’s largest doctors’ lobby.
The changes include modifying the label of prescription opioids to remove “moderate” pain and clarify that the drugs should be reserved for “severe” pain only, Ambrose told delegates to the Canadian Medical Association’s general council meeting in Ottawa.

The federal health minister said she is going to introduce legislation that will reverse the decision taken by her government to allow generic drugmakers to produce their own version of the powerful painkiller, OxyContin.
Rona Ambrose said the government is acting to combat the “silent killer” of prescription drug addiction, as part of a suite of measures that includes ensuring all opioids on the market in Canada include tamper-proof technology and developing new guidelines on prescribing practices for physicians.

TORONTO — Ottawa has issued a national call for proposals to improve prescribing practices for opioids and other drugs that pose a high risk of abuse or addiction.
Federal Health Minister Rona Ambrose says her department has earmarked $3.6-million to develop evidence-based practices for appropriate prescribing of the most commonly abused drugs: opioids, stimulants, sedatives and tranquillizers.
Prescription drugs are now the third most commonly abused substance among Canadian youth, after alcohol and marijuana.

This post New Painkiller Could be Bigger than Oxycodone appeared first on Daily Reckoning.
I never understood addiction until I had a small surgery about 15 years ago. It was minor, but involved some pain.
While I lay on the table, the anesthesiologist gave me a slow drip of a morphine derivative mixed with Valium over about an hour, while doctors worked on me.